Have any of you tried to submit articles or original research to any family
practice journals? What is your reception? I don't think I have come across
any breastfeeding articles in the journals that I read in a long time. Many
of you have have ideas that I would love to see published in journals to
reach my colleagues. Could I inspire or encourage any of you who are seeking
publication to consider the family medicine journals. I think the academy
of Family Medicine would welcome supportive breastfeeding articles.
Denise Punger M.D.
Diplomate, American Board of Family Practice
Fellow, American Academy of Family Medicine
Mother, of William and Scott
>From: Automatic digest processor <[log in to unmask]>
>Reply-To: Lactation Information and Discussion
><[log in to unmask]>
>To: Recipients of LACTNET digests <[log in to unmask]>
>Subject: LACTNET Digest - 16 Jun 1999 (#1999-37)
>Date: Thu, 17 Jun 1999 00:05:53 -0400
>
>There are 8 messages totalling 213 lines in this issue.
>
>Topics of the day:
>
> 1. Ineffective suckling in a 2 month old
> 2. Failed again...
> 3. LACTNET Digest - 16 Jun 1999 - Special issue (#1999-35)
> 4. giardia
> 5. Reflux
> 6. LACTNET Digest - 15 Jun 1999 - Special issue (#1999-32)
> 7. Giardia
> 8. Infant with cystic fibrosis
>
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>
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>----------------------------------------------------------------------
>
>Date: Wed, 16 Jun 1999 20:46:18 EDT
>From: [log in to unmask]
>Subject: Ineffective suckling in a 2 month old
>
>In a message dated 06|16|99 06:57:52 PM, [log in to unmask]
>writes:
>
><< [log in to unmask] >>
>
>If not accomplished already, this baby should be evaluated by a speech and
>communication specialist. We also use an occupational therapist in these
>situations sometimes. This sounds like there is a delay in get his
>neurological house in order. Respond to me privately, as I'm going
>nomail.....VNJ
>
>------------------------------
>
>Date: Thu, 17 Jun 1999 10:54:10 +1000
>From: MARY BLACK <[log in to unmask]>
>Subject: Failed again...
>
>Dear all
>
>Having one of those off days. My client group of young at risk mothers are
>=
>great and we have a lot of robust and breastfeeding mothers and others who
>=
>are absolutely doing the best they can.=20
>
>I have struggled with a particular 17 year old for months and months now. =
>She is an IV user and dealer who used during pregnancy and despite the =
>odds had a lovely healthy baby. She even tried breastfeeding for a while =
>but was on bottles within weeks. She now lives in a dump, is depressed, =
>using and dealing again, has no family near, and the few friends she has =
>lead totally chaotic lives.=20
>
>My main concern now is for the baby, who is small, ignored, and has =
>probably survived by being "good".
>
>So in a sense, I have "failed" and there is a no win situation, because if
>=
>we involve child protection the baby may get put in care ( or not - it is =
>actually quite hard to do this in Australia, still raw after the "stolen =
>generation" and orphanage abuse scandals), or else she will simply =
>disappear and we will never know what happens next.
>
>But I suppose the ultimate failure would be a dead or damaged baby.
>
>Oh well... at least writing it down puts it in perspective. There are =
>times when the importance of supporting breastfeeding just pales beside =
>other concerns.
>
>Mary E Black
>Professor of Public Health
>University of Queensland
>
>------------------------------
>
>Date: Wed, 16 Jun 1999 21:22:13 EDT
>From: lisa mooney RN <[log in to unmask]>
>Subject: Re: LACTNET Digest - 16 Jun 1999 - Special issue (#1999-35)
>
>Rachel, I am currently taking an Operational Preventive Medicine Course
>with
>the Navy, I am a Navy Nurse getting ready for Kosovo. We have some life
>experienced Infectious Disease Docs giving us lectures on such matters as
>Gastrointestinal Infections. Giardia is a protozoan that can be endemic in
>certain areas of the US, UK and Mexico. It does not cause active or
>symptomatic disease in all persons and has a high rate of asymptomatic
>carriers. It generally resides in the small intestine and can cause
>diarrhea,
>steatorhea from malabsorption , fatigue and weight loss. Treatment can also
>be used with Quinicrine or there is a Pediatric Suspension of furazolidone.
>Drug relapses and resistances do occur. I am just wondering if she is
>symptomatic. Route of transmission is from hand to mouth with contaminated
>fecal material or from fresh water sources exposed to animal or human
>waste.
>Chlorinated water that is not filtered also is a source of Giardia Cysts.
>Period of communicability is the entire period of infection, however ,
>handwashing and attention to hygiene can prevent transmission. Hope this is
>helpful, Lisa Mooney RN, BSN, soon to be IBCLC And MPH in the long term
>future.....
>
>------------------------------
>
>Date: Wed, 16 Jun 1999 21:23:17 EDT
>From: [log in to unmask]
>Subject: giardia
>
>giardia (sic) isn't a disease, it is a parasite, and it doesn't run its
>course, it lives with you forever, sometimes, unless your body happens to
>be
>able to oust it without help. you can have a chronic infestation, which
>occasionally flares up to be acute. flagyl is used pediatrically, and while
>it is a serious drug, giardia is a serious problem.
>
>carol brussel IBCLC
>laura nevada lactation
>www.breastfeedinghelp.com
>denver, colorado, the state in which ALL untreated water is assumed to have
>giardia in it
>
>------------------------------
>
>Date: Wed, 16 Jun 1999 20:07:22 -0500
>From: bclesperance <[log in to unmask]>
>Subject: Reflux
>
>I agree with Barbara Wilson-Clay. A baby isn't asymptomatic if he/she is
>crying a painful cry after feedings. I had a baby a few weeks ago,
>crying/squirming during and after feeds-MD called the baby just a "fussy"
>baby. When I made the home visit the baby when crying looked miserable.
>Looked in the baby's mouth-white all over the posterior tongue. Mother says
>that MD told her the baby doesn't have thrush. I said looks like it to me
>and may be why baby is miserable during feeding and after-throat hurts!
>After treatment, baby very happy!
>Carol L'Esperance, RN, MSN, IBCLC
>Albuquerque, NM 87106 USA
>
>------------------------------
>
>Date: Wed, 16 Jun 1999 22:22:49 EDT
>From: lisa mooney RN <[log in to unmask]>
>Subject: Re: LACTNET Digest - 15 Jun 1999 - Special issue (#1999-32)
>
>Lisa, re: the question about hypo vs hyper thyroidism there exists primary
>and secondary hypothyroidism. Secondary hypothyroidism is caused by
>pituitary
>causes and can occassionally cause decreased TSH Levels.T3 and T4 are the
>thyroid hormones . These are produced and secreted in response to TRH and
>TSH, which are regulated by the hypothalamus and TSH from the Anterior
>Pituitary. TRH regulating the secretion of TSH which directly increases or
>decreases the production and release of T3 and T4. The effects of TSH can
>occur in 30 mins where the other responses take days or weeks.This I
>obtained
>from an excellent lab reference book I have. It would look like
>hyperthyroid
>perhaps because when T3 and T4 are increased in the blood stream TSH levels
>decrease, except as the reference book said , occasionally , in secondary
>hypothyroidism, TSH levels can be decreased. What sx does she have besides
>the low milk supply? Lisa Mooney, RN, BSN soon to be IBCLC
>
>------------------------------
>
>Date: Wed, 16 Jun 1999 22:54:43 EDT
>From: [log in to unmask]
>Subject: Giardia
>
>When my very young daughter got giardia her doctor wanted to avoid Flagyl
>and
>prescribed another drug (I believe it started with an M) that killed the
>giardia. Also, I researched about not treating and found out that it is
>next
>to impossible to get rid of totally without treatment because they live so
>high up in the gut. It often can appear cleared up only to resurface after
>awhile.
>
>Sue Wirth, IBCLC
>
>------------------------------
>
>Date: Wed, 16 Jun 1999 23:01:03 EDT
>From: [log in to unmask]
>Subject: Infant with cystic fibrosis
>
>Dear Patty,
> You described the baby at 4 1/2 weeks diagnosed with CF and asked for
>comments as to whether these babies tended to be more fussy or colicky.
>You
>also mentioned this baby was "content" but cried for "30-45 minutes" after
>feedings. That confused me a little.
> Also, the mother's milk supply seems to be in question and her
>perception
>is that he is still hungry.
> If he presented with meconium ileus at birth I am wondering if he had
>surgery or a bowel resection? Since he is taking pancreatic enzymes, she
>could try dosing him before and mid-way during the feedings to make sure
>his
>discomfort isn't stemming from gas and cramping from malabsorption.
> If you have been following the reflux thread-that is another
>possiblity.
>One recent study from Melbourne, Australia of 20 breastfed infants of 26
>concluded 20% of babies under 6 months have a degree of GER.
> It has been my experience that these babies can be fussier because of
>the
>gas produced by malabsorption and/or maldigestion, even when on enzymes.
>Pancreatic insufficiency is progressive and enzymes should be titrated by
>baby's changing weight to be most effective.
> The real bug-a-boo is to weed out what is CF related and what is just
>baby crabbiness (and mom's focus on growth etc/vulnerable child
>theory)..These babies also have higher caloric needs and many believe,
>higher
>resting energy expenditures.
> Please contact me if I can be of any other assistance. Good luck with
>this family....remind her if the baby is fussy on her milk, formula would
>probably be a nightmare (and breastmilk has the enzyme lipase built right
>in!). And forewarn her of Pregestamil ("but it's predigested!") being
>foisted on her if she mentions it to the docs. Her best bet may be the GI
>doc at her CF center.
>
>Heine, Button et al . Gastro-oesophageal reflux in infants under 6 months
>with cystic fibrosis Arch Dis Child 1998: 78:44-48
>
>Jan Ellen Brown RDH IBCLC
>Charlotte, NC
>
>------------------------------
>
>End of LACTNET Digest - 16 Jun 1999 (#1999-37)
>************
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